title: Metatarsal transfer for the treatment of post-axial metatarsal-type foot synpolydactyly: a new technique that allows for comfortable shoe wearing.
abstract: We analysed the clinical and radiological outcomes of a new surgical technique for the treatment of heterozygote post-axial metatarsal-type foot synpolydactyly with HOX-D13 genetic mutations with a mean follow-up of 30.9 months (24 to 42). A total of 57 feet in 36 patients (mean age 6.8 years (2 to 16)) were treated with this new technique, which transfers the distal part of the duplicated fourth metatarsal to the proximal part of the fifth metatarsal. Clinical and radiological assessments were undertaken pre- and post-operatively and any complications were recorded. Final outcomes were evaluated according to the methods described by Phelps and Grogan. Forefoot width was reduced and the lengths of the all reconstructed toes were maintained after surgery. Union was achieved for all the metatarsal osteotomies without any angular deformities. Outcomes at the final assessment were excellent in 51 feet (89%) and good in six (11%). This newly described surgical technique provides for painless, comfortable shoe-wearing after a single, easy-to-perform operation with good clinical, radiological and functional outcomes.
authors.affiliation: Baskent University Hospital, Department of Orthopaedics and Traumatology, Ankara, Turkey. orcunsahin@yahoo.com
authors.forename: O
authors.initials: O
authors.lastname: Sahin
authors.forename: I
authors.initials: I
authors.lastname: Kuru
authors.forename: R C
authors.initials: RC
authors.lastname: Akgun
authors.forename: B S
authors.initials: BS
authors.lastname: Sahin
authors.forename: I D
authors.initials: ID
authors.lastname: Canbeyli
authors.forename: I C
authors.initials: IC
authors.lastname: Tuncay
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005545:Forefoot, Human / Q000000981:diagnostic imaging / Q000601:surgery*; D018398:Homeodomain Proteins / Q000235:genetics; D006801:Humans; D008297:Male; D008682:Metatarsal Bones / Q000000981:diagnostic imaging / Q000637:transplantation*; D008683:Metatarsophalangeal Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012775:Shoes; D013576:Syndactyly / Q000000981:diagnostic imaging / Q000235:genetics / Q000601:surgery*; D014157:Transcription Factors / Q000235:genetics; D016896:Treatment Outcome
chemical_list: C513184:HOXD13 protein, human; D018398:Homeodomain Proteins; D014157:Transcription Factors
keywords: Metatars; Outcome; Post-axial; Radiology; Surgery; Synpolydacytly